The overall goal of my research is to determine if psychosocial processes can function as cofactors and contribute to disease progression in HIV seropositive individuals, and to develop targeted psychosocial interventions that can improve the course of disease. Over the past five years I have characterized the psychosocial responses of HIV positive gay men to two of the primary stressors that occur with the AIDS epidemic: the threat of mortality and bereavement. I have determined that the following responses are associated with immunologic processes prognostic for the development of AIDS: specific affective responses (depression versus grief), affect regulation strategies, negative HIV-specific expectancies and lack of engagement with important life goals. A central immunologic mediator appears to be immune activation. The specific aims for the next five years are 1) to continue to refine the conceptualization and measurement of these responses and their biological correlates, 2) to extend this research by shifting to studies of women with HIV, 3) to determine the biological pathways that underlie these relationships, 4) to evaluate the impact of various intervention strategies on quality of life, immunologic processes and the course of HIV, and 5) to isolate key psychotherapeutic sub-components of effective interventions.